When is the right time to schedule cancer screenings?

Saying it is not the right time to go to the doctor may be convenient in our busy lives or a way to put off paying attention to our health.

When it comes to cancer screenings, “make that phone call and get it done,” says Amy Legghio, CNP, OCN, Nurse Practitioner at Karmanos Cancer Institute’s Women’s Wellness Clinic in Detroit. “Don’t put it off. There’s never a good time to do any of it – just do it.”

Early detection of cancer is a powerful tool in fighting the disease. When it comes to cancer, there are guidelines for every test to help you and your health care provider determine when you should begin screening. The types of cancer screenings vary for men and women.

Cancer screenings for women

Breast cancer screening

Breast cancer is the most common cancer among women in the U.S. Women at average risk of breast cancer should begin annual screening mammograms at age 40. However, women who are considered to be at high risk for breast cancer may require a different screening schedule. For example, if you have had a strong family history of breast cancer, especially a first-degree relative who has had the disease, the American Cancer Society recommends having your first mammogram at age 30.

There are also tests available for women with dense breast tissue.

“This is a conversation that needs to be had with your primary care provider – what mammogram is best for you and when you should start screening,” advised Legghio.

Cervical cancer screening

Cervical cancer was once one of the most common causes of cancer deaths among women, but due to the ability to catch the disease in earlier stages than in the past, the number of cancer deaths due to cervical cancer has declined. Women are encouraged to receive routine gynecologic evaluations, including Papanicolauo (Pap) tests, human papillomavirus (HPV) tests, or both, starting at age 21.

Karmanos recommends the following:

• Women ages 21-29 receive a Pap test every three years
• Women ages 30-65 receive a Pap test and an HPV test every five years
• Women over 65 years old who have not had abnormal test results do not need to be screened
• Women who have had a hysterectomy do not need to be screened

“Women who do not have a history of abnormal Pap smears and women who have been vaccinated with the HPV vaccine still should follow these guidelines. The HPV vaccine does not eliminate the need for screening,” explained Legghio.

Cancer screenings for men

Prostate cancer screening

Prostate cancer is the most commonly diagnosed cancer among men. Men nearing 50 years of age or older should speak with their primary care provider to understand whether they should receive a digital rectal exam (DRE) or routine prostate-specific antigen (PSA) blood test. Each man’s prostate health varies - some men may have to receive screenings at an earlier age, especially if they are considered high risk. This could be true if they:

• Have a family history of prostate cancer, including a father, son or brother who has been diagnosed with prostate cancer before the age of 65. A man’s risk increases when he has more than one close family member who has been diagnosed.
• Are African American. African American men have a higher death rate due to prostate cancer than American men of European descent.

Cancer screenings for both men and women

Colorectal cancer screening

Colorectal cancer is the second-leading cause of cancer deaths among men and women in the U.S. There are usually no symptoms during the early stages of the disease, making regular testing crucial.

“A colonoscopy is important because we can actually prevent cancer by completing this screening,” said Legghio. “If we see a precancerous polyp, we can remove that before it even turns into cancer. If colon cancer is found at later stages, it can be difficult to cure.”

Generally, men and women considered to be at average risk for colon cancer should begin screenings at age 45. If you are considered high risk, your provider may recommend to start screening earlier.

Men and women considered to be at high risk for colon cancers are encouraged to speak with their physician about receiving a colonoscopy. Those who are at high risk usually:

• Are African American. African Americans are recommended to begin screening at an earlier age
• Have a family history of colorectal cancer or other genetic factors, such as Lynch Syndrome
• Have a personal history of colorectal cancer or polyps
• Have Inflammatory Bowel Disease (IBD), also known as Crohn’s Disease or Ulcerative Colitis
• Are obese and/or are physically inactive
• Have a diet that is high in fat or high in red or processed meat, and low in fiber, calcium, fruit and vegetables

If you fall between these guidelines and the results of your first screening are normal, specialists recommend receiving a colonoscopy every 10 years.

“I have conversations about colonoscopies almost every day with my patients. People don’t want to do colonoscopies because they don’t want to deal with the prep,” added Legghio. “Prepping for a colonoscopy and having the procedure itself, which does involve sedation, is a much easier task to complete than actually getting a diagnosis of colon cancer and having to have extensive treatment.”

There are also alternatives for patients who may not be able to undergo a colonoscopy.

Lung cancer screening

If you know that you have been exposed to harmful chemicals and gases (e.g., radon), are a current smoker or have a smoking history, it is a good idea to have a conversation with your primary care provider about getting screened for lung cancer. Even if you quit smoking, you can still be at risk of developing this disease.

Karmanos recommends lung cancer screenings for patients who are:

• 50 - 80 years old
• Current or former smokers with at least a 20 pack-year smoking history (one pack a day for 20 years or two packs a day for 10 years, etc.) and
• Current smokers or those who have quit within the last 15 years.

Lung cancer screenings can be done in as little as 15 minutes.

A referral is not needed to be seen for screening at Karmanos. However, if you have a primary care provider, Karmanos specialists will work with your provider to ensure you receive the screening you need. Call 1-800-KARMANOS, or visit karmanos.org/screening to schedule the appropriate screening for you.